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Cerebral sinus venous thrombosis: clinical and pathogenetic perspectives from Tuscany
Eva Terni1, Nicola Giannini, Alberto Chiti
1Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Italy.
Insights
Cerebral sinus venous thrombosis (CSVT) is a rare stroke type. Identifying risk factors like thrombophilia and using early diagnosis with anticoagulant treatment improves patient outcomes significantly.
Area of Science:
- Neurology
- Vascular Medicine
- Hematology
Background:
- Cerebral sinus venous thrombosis (CSVT) is an uncommon but serious condition, accounting for 0.5-1% of all stroke cases.
- Early detection and comprehensive risk factor assessment are vital for managing CSVT and reducing patient mortality and morbidity.
Purpose of the Study:
- To investigate the clinical presentation and etiological factors associated with CSVT in an Italian patient cohort.
- To highlight the importance of identifying acquired or inherited risk factors for effective CSVT management.
Main Methods:
- Retrospective analysis of clinical data from 43 Italian patients diagnosed with CSVT.
- Evaluation of patient symptoms, demographic information, and identified etiological factors.
Main Results:
- Headache was the most frequent symptom (81.4%), followed by focal signs (20.9%).
- Over 80% of patients had acquired or inherited risk factors, including contraceptive use (74.1% of women), congenital thrombophilia (34.9%), infections, dysthyroidism, and hyperhomocysteinemia.
- Favorable outcomes were observed in over 80% of patients.
Conclusions:
- Early diagnosis and prompt anticoagulant therapy are crucial for improving outcomes in CSVT patients.
- Thorough investigation of both inherited and acquired thrombophilic abnormalities is recommended for all CSVT patients.
Abstract:
Cerebral sinus venous thrombosis (CSVT) is a rare condition representing the 0.5-1% of all stroke cases which can have serious consequences. Early diagnosis and complete screening for acquired or inherited risk factors is crucial for decreasing morbidity and mortality. We have investigated clinical and aetiological factors in an Italian cohort of 43 patients with cerebral sinus venous thrombosis. Common presentation complaints were headache (81.4%), focal signs (20.9%), vomiting (11.6%) and seizures (6.9%). Acquired or inherited conditions were observed in more than 80% of cases. The commonest aetiological factors were contraceptives (74.1% of women), congenital thrombophilia (34.9%), infections and dysthyroidism (16.3%), hyperhomocysteinemia (9.3%), migraine (11.6%), cranial trauma (9.3%) and chronic myeloproliferative diseases (11.6%). Outcome was favourable in more than 80% of patients. Early diagnosis and anticoagulant treatment may decrease mortality and/or morbidity rates related with CVST in these patients. Thrombophilic abnormalities, either inherited or acquired, are worthy to be widely investigated.